The Effectiveness of Pitch-raising Surgery in Male-to-Female Transsexuals: A Systematic Review.

OBJECTIVES: This study aimed to review the evidence of the effectiveness of pitch-raising surgery performed in male-to-female transsexuals.

METHODS: A search for studies was performed in PubMed, Web of Science, Science Direct, EBSCOhost, Google Scholar, and the references in retrieved manuscripts, using as keywords "transsexual" or "transgender" combined with terms related to voice surgery. We included eight studies using cricothyroid approximation, six studies using anterior glottal web formation, and six studies using other surgery types or a combination of surgical techniques, leading to 20 studies in total.

RESULTS: Objectively, a substantial rise in postoperative fundamental frequency was identified. Perceptually, mainly laryngeal web formation seems risky for decreasing voice quality. The majority of patients seemed satisfied with the outcome. However, none of the studies used a control group and randomization process. Further investigation regarding long-term results is necessary.

CONCLUSION: Future research needs to investigate long-term effects of pitch-raising surgery using a stronger study design.